Sports physician warns against heat illnesses in athletes

HAYS COUNTY — As summer comes to an end and school begins, students are preparing to enter the sports season in the ever-climbing temperatures of Central Texas. According to Dr. Leigh Romero, a primary care sports medicine physician at Ascension Seton in Austin, there are 9,000 heat related illnesses reported annually in high school sports and they are the third most common cause of death in athletes.

There are three types of heat-related illnesses: heat cramping, heat exhaustion and heat stroke. The latter being the most dangerous.

Heat cramping occurs when the muscles get too tight and cause pain, often from dehydration. By hydrating and stretching well, athletes can manage this illness.

Dr. Romero explained that, while some people use the terms heat stroke and heat exhaustion interchangeably, they are different illnesses.

“The main difference between [heat exhaustion and heat stroke] is heat stroke is when you have a temperature, a core temperature, so usually a rectal temperature, of 104 [degrees] or higher and you also have confusion. They’re disoriented and they may not know exactly where they’re at,” she said. “Whereas heat exhaustion has all of the symptoms: headache, nausea, vomiting, cramping [and] profuse sweating. Those symptoms are the same in both, but it doesn’t have that confusion.”

Heat stroke is the most serious of these illnesses and can lead to death due to organs failing from the extreme core temperature.

Many schools have a trainer that attends games and practices in order to spot concerning symptoms in students, so they are aware when it is time to pull the student aside to recover.

Despite having trained professionals available, it’s important that parents and students are aware of the warning signs. This way, if they notice that their child or friend is acting strangely, they can proceed immediately  into cooling methods.

According to Dr. Romero, some of the most helpful techniques are:

• Removing unnecessary clothing

• Getting into air conditioning

• Hydrating

• Placing ice on key points of the body, such as the groin and neck

• Dunking into an ice bath — the number one method for preventing heat stroke — because it rapidly cools the body’s temperature

Though there is always the risk when participating in any activity outside, including sports, dance or band practice, there are ways to prepare individuals for the heat. Wearing lightweight and light colored clothing, hydrating with both water and electrolytes, getting a good night’s sleep, resting when unwell, staying fit in the off season and taking the time to get your body acclimated to the heat are all helpful steps to avoid heat related illnesses.

“The clothing and equipment is a big deal because obviously in football, they have helmets, they have shoulder pads, they have full pads, so for high school football, they have a 14-day acclimatization period,” said Dr. Romero. “[Some] days, they can only do helmets and that’s it. Then, they can start adding shoulder pads and then they can start adding full pads. That way, it’s kind of slowly entered in, so the kids can start to kind of get used to the heat. Because the more equipment you have on you, obviously you can’t sweat and you can’t dissipate heat.”

Coaches can decrease the risk for heat-related illnesses by hosting practices in early hours of the day, doing walkthroughs indoors when permitted, providing breaks between practices, allowing time for students to be in shade and take water breaks, as well as following the acclimatization period.

Dr. Romero also warned to pay attention to medications athletes are taking, such as medicines for ADHD or SSRIs, as they can affect the body’s ability to release heat due to the chemicals. Students with various diseases, such as sickle cell, should also be monitored with preparation to adjust practices as needed.

For more information, visit www.cdc.gov/disasters/extremeheat/heattips.